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From the 6/4/2021 release of VAERS data:

This is VAERS ID 1246503



Case Details

VAERS ID: 1246503 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flovent, Simvastatin, Zyrtec, and Ventolin
Current Illness: Hyperlipidemia
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient given vaccine at 17 years and 8 months of age when he should have been 18. No adverse effects noted day of vaccine or following day when staff called to check on him.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1246503


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